Nuclear survivin in pN2 nonsmall cell lung cancer: prognostic and clinical implications
Nuclear survivin in pN2 nonsmall cell lung cancer: prognostic and clinical implications
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DOI：
10.1183/09031936.00068708
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发表时间：
2009-01-01
影响因子：
24.3
通讯作者：
Yoshino, I.
中科院分区：
文献类型：
--
作者：
Mohamed, S.;Yasufuku, K.;Yoshino, I.
N2非小细胞肺癌（N2-NSCLC）患者代表异质性组。Survivin是凋亡抑制因子家族的成员。如果N2-NSCLC患者可以分层，根据生存素表达和/或其与细胞周期蛋白的关系，到同质的亚组，某些治疗可以选择为这些patients.Survivin表达在78例手术切除的原发病理N2-NSCLC肿瘤进行了评估，使用免疫组化。分析survivin表达与总生存期、临床特征及6种细胞周期相关蛋白（pRb、cyclin D1、p16（INK 4A）、p53、p21（Waf 1）和Ki-67）表达的关系，并以核survivin和纵隔淋巴结（LN）数目作为独立预后因素。生存素阴性/纵隔淋巴结单一分期者预后最好，且与临床淋巴结因素有关。事实上，阴性生存素/低Ki-67标记指数的患者有最好的生存，特别是在nonsquamous组织病理学。目前的作者得出结论，核生存素是密切相关的病理N2非小细胞肺癌患者的淋巴结转移和增殖潜力。术前N2非小细胞肺癌患者联合阴性核生存素和一个单一的纵隔淋巴结站，或低增殖指数，特别是在临床N 0 -1疾病和非鳞状组织病理学，分别预计有一个良好的术后预后，并可能是一个主要切除的候选人。
Patients with N2 nonsmall cell lung cancer (N2-NSCLC) represent heterogeneous groups. Survivin is a member of the inhibitor of apoptosis family. If N2-NSCLC patients could be stratified, based on survivin expression and/or its relation to cell cycle proteins, into homogeneous subgroups, certain therapies could be selected for those patients.Survivin expression in 78 surgically resected primary pathological N2-NSCLC tumours was evaluated using immunohistochemistry. Relationships of survivin expression to overall survival, clinical features and expression of six cell cycle-related proteins (pRb, cyclin D1, p16(INK4A), p53, p21(Waf1) and Ki-67) were analysed.Nuclear survivin and the number of mediastinal lymph node (LN) stations were independent prognostic factors. The patient group with combined negative survivin/single mediastinal LN station were the most favourable prognostic group, and was related to the clinical nodal factor. Indeed, patients with negative survivin/low Ki-67 labelling indices had the best survival, especially in nonsquamous histopathology.The current authors conclude that nuclear survivin is strongly related to lymph node metastasis and proliferative potentials in pathological N2 nonsmall cell lung cancer patients. Pre-operative N2 nonsmall cell lung cancer patients with combined negative nuclear survivin and a single mediastinal lymph node station, or low proliferative indices, particularly in clinical N0-1 disease and nonsquamous histopathology, respectively, are expected to have a favourable post-operative prognosis and may be candidates for primary resection.